| NPI | 1841665528 |
|---|---|
| Former Name | DOREEN JOY BENCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 385H00000X Respite Care (Licence: MN 1078862-1-AFC) |
| Additional Taxonomies | 385H00000X Respite Care (Licence: MN 1078276-1-HCBS) |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2015-12-07 |